Geographic variation in the clinical features of Mohave rattlesnake (Crotalus scutulatus) envenomations reported to the North American Snakebite Registry

IF 3.6 Q2 TOXICOLOGY
Spencer Greene , Matthew Gilbert , Brian Wolk , Sharan Campleman , Anne-Michelle Ruha , on behalf of the ToxIC Snakebite Study Group
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Abstract

The geographic variation of Mohave rattlesnake (Crotalus scutulatus) venom is well established. We reviewed all the Mohave rattlesnake bites reported to the Toxicology Investigators Consortium's North American Snakebite Registry between January 1, 2015 and 12/31/2021. Data reviewed for this study included details regarding the snake encounter, patient demographics, signs and symptoms, treatment, and outcomes. Our objective was to describe the epidemiology, clinical manifestations, and management of Mohave rattlesnake envenomations using prospective data from two geographically distinct sites. There were 20 subjects, including eight nonpregnant females. Ages ranged from seven to 75 years, median age 48. Nine of the bites were managed in Arizona and 11 in California. In Arizona, all envenomated patients had local swelling. None had neurological toxicity. In California, swelling was present in nine patients. Neurological effects were observed in five subjects. Four Arizona patients and one California patient had hypotension requiring treatment. Each site had one patient with thrombocytopenia. An Arizona patient who sustained a bite to the face was intubated. Rhabdomyolysis occurred in two California patients. All envenomated patients received antivenom. Mohave rattlesnakes have the potential to cause significant local and/or systemic toxicity. Neurotoxicity was not observed in envenomations from Mohave rattlesnakes that presumably lack Mohave toxin, but hypotension and gastrointestinal signs were more common than in bites from snakes believed to possess Mohave toxin. Neurological toxicity was limited to paresthesias and fasciculations. Significant skeletal or respiratory muscle weakness was not observed in our study population.

Abstract Image

向北美蛇咬伤登记处报告的莫哈维响尾蛇(Crotalus scutulatus)中毒的临床特征的地理变异
莫哈维响尾蛇(Crotalus scutulatus)毒液的地理变异已经得到了很好的证实。我们回顾了2015年1月1日至2021年12月31日期间向毒理学调查协会北美蛇咬伤登记处报告的所有莫哈维响尾蛇咬伤。本研究回顾的数据包括与蛇接触的细节、患者人口统计、体征和症状、治疗和结果。我们的目的是描述莫哈维响尾蛇中毒的流行病学、临床表现和管理,使用来自两个地理位置不同的地点的前瞻性数据。共有20名受试者,包括8名未怀孕的女性。年龄从7岁到75岁不等,中位年龄48岁。其中9个在亚利桑那州,11个在加利福尼亚州。在亚利桑那州,所有中毒患者都有局部肿胀。没有一例具有神经毒性。在加州,9名患者出现肿胀。在5名受试者中观察到神经学效应。四名亚利桑那州患者和一名加州患者患有低血压,需要治疗。每个部位有1例血小板减少患者。亚利桑那州的一名患者因面部被咬伤而接受了插管治疗。两名加州患者出现横纹肌溶解。所有中毒患者均接受抗蛇毒血清治疗。莫哈维响尾蛇有可能造成严重的局部和/或全身毒性。在可能缺乏莫哈维毒素的莫哈维响尾蛇的毒液中没有观察到神经毒性,但低血压和胃肠道症状比被认为含有莫哈维毒素的蛇咬伤更常见。神经毒性仅限于感觉异常和束控。在我们的研究人群中没有观察到明显的骨骼肌或呼吸肌无力。
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来源期刊
Toxicon: X
Toxicon: X Pharmacology, Toxicology and Pharmaceutics-Toxicology
CiteScore
6.50
自引率
0.00%
发文量
33
审稿时长
14 weeks
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